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Combating cancer, injury and disfigurement in the most socially important part of our bodies – the face and mouth

The face is the only part of our body we cannot hide. It conveys our emotions and innermost feelings. We often judge each other on the basis of facial appearance, making assumptions on a whole range of issues.

People suffer the consequences of facial diseases, injuries and disfigurement every day. In the United Kingdom 6,500 people develop oral cancer every year. Around 125,000 young people sustain serious facial injuries and 15,000 people receive treatment for facial disfigurement.

Despite the severity of these issues, this remains a much neglected research area leaving thousands of those unfortunate enough to be affected with little hope for the future. Not enough is known about facial disease, injury and deformity, their psychological and emotional impact and, critically, which treatments are most effective. Saving Faces - The Facial Surgery Research Foundation is the only charity in the UK solely dedicated to the worldwide reduction of facial injuries and diseases. We are taking the lead in education and research to improve the physical and psychological treatment of all victims of oral cancer and other facial diseases.

At the time of painting, Henry was a 34-year-old forensic mental health nurse working in a behaviour modification unit in London. He lived with his wife Gloria and two-year-old son Jeremiah.

His story starts in Nigeria in 1991 where he underwent several operations culminating in the removal of all his right upper jaw and maxillary sinus for what was thought to be a benign tumour. In fact it was a malignant bone tumour (osteosarcoma). He sought treatment from lain Hutchison in the UK but was advised that because of the position of the tumour an unacceptable amount of his face would need to be excised to achieve its total removal.

With the help of friends, family and his employer, Henry raised enough funds to pay for his travel, hospital and accommodation bills.

When he arrived in the UK in 1991 the tumour was growing at four separate sites: the roof of his nose and bulging out through the right side of his nose; behind his right eye pushing this forward; in his right cheekbone and in his right temple, destroying the skull and facial bones at these sites.

He was immediately treated with chemotherapy for six months. He then underwent a twenty-hour operation in which his nose, right face including skin and underlying bone, right eye, right temple, and the bones separating his brain from his eye socket and nose were removed. This area was built up using rib to reconstruct the underlying facial architecture, latissimus dorsi muscle from the back to seal the space between the brain and the mouth, and skin from the back to replace lost skin. After this he received a six-week radiotherapy course. The tumour recurred five years later, in 1996, on the left side of his upper jaw. On this occasion Henry's left upper jaw, sinus and nasal support were removed. No surgical reconstruction was carried out, but he was fitted with a large denture (obturator) to fill the space.